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Introduction: The higher prevalence of stroke in the elderly population is increasingly recognized, but safety and efficacy of thrombolysis in this population are still debatable in clinical practice. Methods: This is a retrospective cohort study of stroke patients admitted in a health center in Brazil. We investigated the effectiveness of thrombolysis in stroke patients aged above 80y. The primary outcome was Rankin at discharge and the secondary outcome was lethality. Results: We studied a cohort of 185 stroke patients aged above 80. Mean age was 84.9 (standard deviation [SD] 4.1). The majority was female (121–65.4%). Mean initial National Institute of Health Stroke Scale (NIHSS) was 12.2 (SD 6.7). Most patients had arterial hypertension (83.2%) with equal proportion between sexes. Thrombolysis was performed in 20.8%. The proportion of risk factors was the same for those who received or not thrombolytic therapy. Age, Aspects score, and comorbidity index were similar for the groups, as was the proportion of female/male. The rate of in-hospital infection was insignificantly higher in the non-thrombolytic group (34.9% for non-thrombolytic group and 25% for the thrombolytic one; P = 0.285). NIHSS was significantly higher for the thrombolytic group (14.6 versus 10.9 points – P = 0.0007). The rate of case-fatality was 30.1% for the non-thrombolytic group and 19.3% for those treated with thrombolysis. A multivariate logistic regression analysis disclosed in-hospital infection as the main predictor of lethality (odds ratio [OR] 3.1; CI 1.33–7.15; P < 0.0001) for both groups. Predictors of a good outcome at discharge (Rankin score ≤ 2) included a lower initial NIHSS score and the treatment with thrombolysis (adjusted OR 5.3; CI 1.79–15.80). Conclusion: Thrombolysis in stroke patients aged 80 years was safe and effective, disclosing the strongest predictor of good short-term outcome.

Objetivo: relatar o caso de um paciente portador de oclusão aterosclerótica da aorta abdominal cuja vascularização dos membros inferiores era mantida por colaterais mesentéricas com reenchimento retrógrado da aorta distal. Método: as informações foram obtidas por meio de revisão do prontuário, entrevista com o paciente, registro fotográfico dos métodos diagnósticos aos quais o paciente foi submetido e revisão da literatura. Considerações finais: o caso relatado e publicações levantadas trazem à luz a discussão da terapêutica de uma situação complexa que é a doença oclusiva aortoilíaca e evidenciam que, embora adotada em uma minoria de casos, quando bem executada e em pacientes adequadamente selecionados, a endarterectomia aórtica é capaz de obter resultados satisfatórios e duradouros no que diz respeito ao alívio sintomático e melhoria da qualidade de vida.

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